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These associations were more pronounced in women with depressive symptoms compared with those without depressive symptoms.

Introduction

In contrast, the significant positive associations observed in men without depressive symptoms were not found in men with depressive symptoms. Our findings are also supported by experimental studies. Participants with higher EmE scores ate more potato chips and chocolate candies during a sad movie or after a stress task compared with those with lower EmE scores 2. Similar results were found for sweet high-fat food intake cake and chocolate biscuits only, when participants were exposed to a wide range of sweet, salty, and bland foods with low- and high-fat content 3.

Another study found that emotional eaters were more likely to report overeating of chocolate, potato chips, and biscuits under stress, although these results were not replicated in a laboratory experiment after an ego-threatening task In contrast, other authors did not observe such a moderator effect of EmE after 4 emotion inductions: The authors challenged epidemiologic results arguing that it is difficult to assess oneself as an emotional eater. Van Strien et al. Our results suggest that energy-dense snacks would be preferentially consumed in response to negative emotions, supporting the hypothesis that some foods have particular qualities that make them more comforting than others Energy-dense foods that are generally rich in fats and often in added sugars are palatable, easily accessible, and convenient 35 , It was shown that eating palatable foods reduced negative mood in the short run, especially among emotional eaters The underlying mechanism could be a difference in sensitivity to the reward properties of food in emotional eaters compared with non-emotional eaters 38 , However, it remains unclear whether emotional eaters show a deficit of perceived reward 39 or rather heightened sensitivity to palatable food reward in the context of negative mood It is also possible that the consumption of such foods rely on their ability to distract from negative emotions in emotional eaters Sugar may act as an enhancer of palatability of fat-rich foods, strengthening hedonic preferences for them Evidence in the literature is conflicting regarding the association between EmE and sugary product consumption 3 — 5.

A potential explanation for the discrepancies might be that these products are sometimes grouped together with chocolate and other confectionaries, perhaps obscuring the association. Regarding soft-drink consumption, artificially but not sugar-sweetened soft drinks were associated with EmE, as observed previously This finding suggests the importance of product flavor rather than post-ingestion affective experiences.

Women had higher EmE scores than did men, in line with data in the literature 4 , 6 , 8 , Women also had higher daily energy-adjusted mean consumption of all energy-dense food groups studied, except for cheese and processed meat.

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Associations between EmE and consumption of energy-dense snack foods were found in both women and men, with generally stronger associations in women. These sex differences could be explained by the fact that comfort-food preferences are influenced by sex, with women preferring sweet snack foods Previous studies showed similar associations between EmE and consumption of sweet energy-dense food in both sexes 4 , 6 , an association with intake of sweets in women only 5 , or of non-sweet energy-dense foods in men only 6.

In our study, we found a positive association between EmE and higher energy intake in women only. Previous studies showed diverging results, with no association in young women 7 , no association in both men and women 8 , or a positive association in men only 4.

Our results suggest that EmE is associated with increased energy intake and unhealthy food choice in women, whereas it is only associated with unhealthy food choices in men. In addition, the observed sex-specific association between EmE and energy intake suggests that women consume larger portions of energy-dense foods in response to a negative emotion. Greater consumption of other food groups is unlikely because we found no sex differences for the associations between EmE and other food groups data not shown. It is also possible that men counterbalance their intake on other eating occasions.

These discrepancies might be due to ovarian hormones that were shown to predict changes in EmE across the menstrual cycle, suggesting that women would be more susceptible to engage in EmE at some hormonal phases Overall, macronutrient intakes were unrelated to EmE, consistent with previous reports in the literature 4 , 7 , 8.

As expected, individuals with depressive symptoms scored higher on the EmE scale compared with individuals without depressive symptoms. Our findings extend current knowledge of the relation between depression 16 or higher depressive symptoms 6 , 15 and higher EmE. In the present study, we found a differential effect of the presence of depressive symptoms on the EmE—food intake association in subgroups of men and women.

In women, the presence of depressive symptoms strengthened the EmE—food intake association, whereas EmE no longer influenced energy-dense snack-food consumption in men with depressive symptoms. The nonsignificant results in men with depressive symptoms did not confirm our initial hypothesis postulating that depressive symptoms would exacerbate EmE. However, these contrasted results could be partly explained by the fact that depressive symptom expression is not uniform in men and women 19 , Men generally report decrease appetite 19 , This might explain why men with depressive symptoms did not have higher intake of the food groups of interest, while reporting EmE.

They might experience relatively few EmE episodes or episodes of relatively low intensity, with intake of small portions of energy-dense foods. They might also compensate consumption over other meal occasions. In contrast, women with depressive symptoms often show atypical symptoms, such as mood reactivity in combination with weight gain or increased appetite 19 , 20 , which might lead to increased intake of energy-dense food, as seen in the present study. Another potential explanation of the discrepancy between men and women in relation to depressive symptoms could be due to an interaction with genetic vulnerability.

Among older adolescents, the serotonin-transporter gene-linked polymorphic region genotype was shown to moderate the relation between depressive feelings and an increase in EmE in females only The main strength of our study was its large sample size, providing high statistical power. Furthermore, the use of the Internet for data collection probably mitigates social desirability bias and therefore reduces the risk of underestimation of depressive symptoms or underreporting of energy-dense food intake It also allowed gaining access to a vast heterogeneous sample of volunteers and assessing a wide range of sociodemographic and lifestyle characteristics to effectively control for potential confounding factors In addition, the Web-based tool for h dietary data collection has established reliability properties The TFEQ-R21 was validated and emerged as robust regarding factor structure and construct validity 24 with good internal consistency A limitation of the study was its cross-sectional design, which prevented inference of causality.

EmE was assessed 14 mo after inclusion, before depressive symptoms 26 mo after inclusion. However, EmE was suggested to be robust to assessment timing 2. The h dietary records were collected over 2 y. For most participants, h dietary records were concomitant with EmE and depressive symptoms assessment.

Compared with national estimates 49 , our sample had a larger proportion of women A selection bias might also have occurred as a result of the exclusion of individuals and, in particular, h dietary records underreporters that were more often men, were older, and had lower education level and higher BMI. Although we controlled for various characteristics that usually differed between men and women, we cannot exclude that some characteristics were not taken into account.

Next, although the CES-D is a widely accepted measurement tool for depressive symptomatology, some items were shown to be sex biased 50 , The CES-D might have reduced sensitivity in capturing depressive symptomatology in men compared with women, possibly leading to misclassification. We observed a positive association between EmE and energy-dense snack-food intake, with effect modification by sex and depressive symptomatology.

In women, the presence of depressive symptoms exacerbated this association. Conversely, the significant positive associations observed in men without depressive symptoms were not found in men with depressive symptoms. These findings call for a consideration of individual psychologic states when aiming at decreasing unhealthy dietary habits, especially in women. Prospective studies are needed to identify causal links and investigate possible mechanisms underlying the associations among EmE, food consumption, and weight status. All authors read and approved the final manuscript. Oxford University Press is a department of the University of Oxford.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Close mobile search navigation Article navigation. Abstract In recent years, emotional eating EmE has incited substantial research interest as an important psychologic determinant of food intake and overweight. The Three-Factor Eating Questionnaire-R18 is able to distinguish among different eating patterns in a general population. Consumption of fruit, vegetables, sweets and soft drinks are associated with psychological dimensions of eating behaviour in parents and their year-old children.

Emotional eating, depressive symptoms and self-reported food consumption. Dietary intakes, eating style and overweight in the Stanislas Family Study. Disability-adjusted life years DALYs for diseases and injuries in 21 regions, — Evidence for prospective associations among depression and obesity in population-based studies. Overweight, obesity, and depression: Examining the temporal relationship between depression and obesity: The association between diet quality, dietary patterns and depression in adults: Associations between depressive symptoms, self-efficacy, eating styles, exercise and body mass index in women.

Emotional eating and physical activity self-efficacy as pathways in the association between depressive symptoms and adiposity indicators. Possible pathways between depression, emotional and external eating. A structural equation model.

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Emotional eating in adolescents: Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults: Gender differences in symptomatic profiles of depression: Validation of the photo manual used for the collection of dietary data in the SU. Critical evaluation of energy intake using the Goldberg cut-off for energy intake: A practical guide to its calculation, use and limitations.

World Cancer Research Fund. Genetic and environmental influences on eating behavior: Sex and dieting modify the association between emotional eating and weight status. International physical activity questionnaire: The rationale for using open-ended methods was to facilitate capturing situational specific features related to emotional responses Devonport et al. Actigraphy provides a relatively objective non-invasive method of direct measurement of movement and indirect assessment of sleep Ancoli-Israel et al. The recording epoch was set to one minute to allow sufficient memory storage for the entire race.

The following sleep parameters were examined for every h period and per sleep episode automatically calculated from the software: Energy balance was assessed by calculating differences between energy intake and energy expenditure. Energy intake was assessed via the use of weighed food diaries which were recorded by support staff prior to each meal throughout the duration of the event. Energy expenditure was determined by using the Doubly Labelled Water method as reported previously Hulton et al.

MANOVA was used to examine changes in emotion over time with the expectation that there would be significant differences. Emotion data were compared against functional and dysfunctional data and analysed using chisquared. Qualitative data were analysed by coding into themes. The cyclists completed the km race distance in a time of six days 10 hours and 51 minutes, finishing in third place. As a result of a mechanical failure that occurred in an actigraph before the start of the race there was no actigraphy data for cyclist four in pair two, therefore, that cyclist was excluded from all analyses.

To account for individual differences, we examined how emotions compared with each cyclists self-assessment of their optimal emotional state Figure 1. Cyclist 1 and cyclist 2 reported that optimal performance was associated with experiencing moderate scores for vigour, calmness and happiness. In contrast, cyclist 3 reported optimal performance associated with feeling high vigour, happiness and calmness coupled with moderate anger and tension.

In terms of emotions associated with dysfunctional performance, there was a common profile of reporting low vigour, calmness, happiness coupled with high scores of anger, confusion, depression, fatigue and tension. Emotions that riders experienced when performing successfully Optimal-Functional and unsuccessfully Dysfunctional.

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The most dramatic change occurred between days one and two in which cyclists reported an emotional profile similar to the one reported for dysfunctional performance Figure 2. Qualitative data provide accounts of the acute challenges presented by the demands of the race. Quotes are used to illustrate the key themes. Cyclists reported anticipated emotions in relation to demands of the event and how they would cope with riding 12 h per day for a seven-day period. Riders also expressed aspects of the race where they experienced pleasant emotions.

A source of intense emotions came from cyclists having difficulty regulating emotions when interacting with members of the support crew and other team cyclists. Incidents tended to occur around food and sleep related issues. For example, one cyclist expressed the following quote after being offered a meal that was not the food he requested. Cyclists also indicated how relationships with other members could influence their emotions. For example, following the incident from the quote above where the cyclist visibly lost his temper, the cyclist expressed the following quote:.

The only person who I found comfort from was XX support crew - they did not say a word, just made me some toast and rubbed my calves. Just a nod was good enough for me to realise that he knew what I was going through and that next time he would take control and get this done. The importance of team building is illustrated through the following two quotes. Here the cyclist speaks about the perceived sense of support from another cyclist motivating him. Whereas in the second quote speaks about anticipatory anger based on how other cyclists and support members might be judging him. I had such a joyous time that I can put my hand on my heart and say that we did not have one cross word.

I could only drink water and not any of the energy drink - however, I was about to start my 1st 6hr night shift and felt very nervous that I wouldn't make it through as I felt the pace of the firstthree hours.

Energy Drinks

On average cyclists managed less than 2. Cyclists attained an almost three-fold increase in the amount of actual sleep and higher sleep efficiency during long compared to short sleep episodes Table 1. Actual sleep and sleep efficiency Figure 4 were maintained better in these long sleep episodes as the race progressed, with greater deteriorations in sleep quality and quantity during short sleep episodes. For example, in the last six sleep attempts cyclist 2 recorded just nine minutes of sleep in contrast to and min for cyclists 1 and 3. The present study examined the emotional responses of cyclists when competing in a four-man team in the RAAM.

All cyclists were found to be in a sleep deprived and negative energy balance state from the first day of the race Hulton et al. The fluctuation of emotions documented throughout the RAAM is consistent with previous research that has examined emotional profiles in multistage ultra-endurance athletes Lane and Wilson, ; Pedlar et al. In the present study, we examined emotional state in relation to whether cyclists were close to their self-reported optimal emotional state. Consistent with previous research Hanin, , optimal-functional emotional states were individualised.

As Figure 1 indicates, cyclist three indicated that moderately high scores of anger and tension were associated with optimal performance.

He also reported scores that were close to the maximum score on the self-report scale for the same two emotions when he performed poorly Hanin, ; Lane et al. The individualised nature of beliefs related to emotional states associated with functional performance presents a challenge for an athlete or member of a support crew wishing to help athlete manage emotional states. We suggest that identification of emotions that athletes believe are functional represents a starting point for applied work designed to help emotion regulation.

However, it is worth noting that there was greater consistency between the three cyclists for emotional profiles associated with dysfunctional performance, consistent with an inverse iceberg profile Raglin and Morgan, Qualitative results indicated that there were instances where cyclists anticipated physiological sensations as an indication of effort made towards attaining personal goals.

If a cyclist perceived he was likely to attain performance goals, then sensations of fatigue coincided with also experiencing pleasant emotions Beedie et al. However, fatigue did not always correlate with feeling pleasant emotions, but also coupled an increase in unpleasant emotions in certain situations. In such instances, frustration resulted when cyclists began to interpret sensations of fatigue as being indicative of their inability to cope Beedie et al.

The incident when the cyclist became angry over the food prepared for him is indicative of this point. The cyclist held firm beliefs that one type of food would be beneficial for recovery and the discrepancy with what was provided served to engender a belief that he would not be able to perform adequately in the next ride. Qualitative comments indicate that cyclists held beliefs on the need to maintain the race pacing strategy and anticipated the emotional states of other cyclists.

In short, each cyclist expressed the idea of not performing poorly so as not to let the other cyclist down and such thoughts were accompanied by unpleasant emotions. Qualitative data also indicate how cyclists regulated their emotions against a backdrop of insufficient sleep and difficulties maintaining energy requirements.

Extrapolating arguments within the strength model Gailliot and Baumeister, , acts of self-control should have been progressively more difficult as the event continued. During the RAAM, cyclists experienced dysfunctional emotions during the early and later stages of the event. However, research has emphasised the role of motivational factors on self-control. Beedie and Lane, recently proposed a resource allocation model, arguing that individuals will seek to recruit more resources if situational demands require them.

Qualitative results indicate the importance of maintaining the race strategy and how cyclists sought to allocate resources required to ride at the proposed intensity for the riding itself. Accordingly, strong beliefs in emotional control associate with regulating emotional states at an optimal intensity, requiring fewer resources Niven et al. Therefore, strategies that promote developing strong beliefs in being able to control emotions may be beneficial for athletes wishing to participate in multiday ultra-endurance events.

Possibly the most important variable impacting upon multiday ultra-endurance performance is recovery between bouts. The present study demonstrates progressive sleep disruption for all cyclists, evidenced by the low sleep efficiency, and high sleep latency and percentage moving times Table 1. Yet the most controllable factor affecting sleep is how the cyclists approached the cycle to rest strategy. The cycle to rest and sleep strategy was designed to promote sufficient recovery and maintain the target speed 8.

Results demonstrated that cyclists attained an almost three-fold increase in the amount of actual sleep and higher sleep efficiency during 6h rest periods compared to 3h rest periods. Thus, the strategy of two 3h work periods during the day may have in fact increased the possibility of increasing physiological and psychological fatigue caused by a lack of both non-Rapid Eye Movement REM and REM sleep. In normal conditions as sleep progresses, the amount of time spent in non-REM decreases, whilst REM sleep significantly increases Horne, Given the low actual sleep times observed during the two daily 3h rest bouts, it is reasonable to assume that non-REM sleep would have been severely impacted and REM sleep would have been extremely low throughout the RAAM.

During Non-REM sleep, brain and core body temperature decrease, providing several responses including lowering energy utilisation, and reducing cerebral metabolism, protecting the brain against the sustained high temperatures of wakefulness, and facilitation of immune defense processes McGinty and Szymusiak, Therefore, given the cyclists sleep deprived states, the proposed thermoregulatory and potential energy restoration benefits of non-REM sleep are potentially lost, resulting in cyclists experiencing greater energy losses and decreased feeding drives as a consequence of REM deprivation.

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When sleep is attempted at a time during the circadian cycle not optimal for a major sleep episode, i. Either result has the ultimate effect of lowering the total amount of sleep time Lack and Wright, b. All cyclists experienced increased sleep latencies compared to baseline levels, consistent with the effects of a desynchronisation between endogenous circadian rhythm and sleep-wake cycles Liu et al.

It is also noteworthy that not only did cyclist two Figure 3 have the lowest amount of actual sleep Table 1 , but also had the greatest difficulty falling asleep. When seen collectively, results demonstrate poor sleep duration and quality, and inadequate energy intake, all of which may have impacted upon the cyclist's emotional regulation. Our data suggests that RAAM strategies should focus upon lengthening sleep periods promoting REM sleep, to potentially decrease wakefulness and sleep latency leading to the possibility of improved physiological recovery, enhanced emotion regulation, improved feeding strategies and most importantly, increased average velocity.

There are two limitations to the present study. The first limitation is the small sample size, although it should be noted that other studies have used small sample sizes Pedlar et al. Secondly, our data do not generalise to women and may not be representative of female endurance cyclists; who represent a growing athletic population that require further investigation in their own right. The intention of the present study was not to suggest findings that generalise to other ultra-endurance groups, but offer a case study that illustrates intra-individual differences.

The case in point is clearly illustrated by the results that show beliefs on the perceived functionality of emotions are highly individualised see Figure 1. Multiday ultra-endurance races such as the RAAM present athletes with a significant number of physiological and psychological challenges. Coupled with this emotional disturbance was a progressively worsening sleep deprivation and negative energy balance throughout the RAAM.